SLOAN V. VICORP RESTAURANT, INC.
Page 4
BEFORE THE IOWA WORKERS’ COMPENSATION COMMISSIONER
______
:
LELAH SLOAN, :
:
Claimant, :
:
vs. :
: File No. 1161209
VICORP RESTAURANT, INC., :
: A R B I T R A T I O N
Employer, :
: D E C I S I O N
and :
:
KEMPER NATIONAL INSURANCE CO., :
:
Insurance Carrier, :
Defendants. :
______
STATEMENT OF THE CASE
Lelah Sloan, the claimant, seeks workers’ compensation benefits from defendants, Vicorp Restaurant, Inc., the alleged employer, and its insurer, Kemper National Insurance Co.. Presiding in this matter is Larry P. Walshire, a deputy Iowa workers’ compensation commissioner. I heard the claim on April 25, 2000. The oral testimonies and written exhibits received during the hearing are set forth in the hearing transcript.
The parties agreed to the following matters in a written hearing report submitted at hearing:
1. An employee-employer relationship existed between claimant and Vicorp Restaurant, Inc., at the time of the alleged injury.
2. Claimant is not seeking weekly disability benefits.
3. The fees and charges involved in the requested medical benefits are fair and reasonable. The parties stipulated that the providers of the requested medical expenses would testify as to the reasonableness of the treatment and defendants are not offering contrary evidence.
ISSUES
The parties submitted the following issues for determination in this proceeding:
I. Whether claimant received an injury arising out of and in the course of employment;
II. The extent of claimant's entitlement to medical benefits.
FINDINGS OF FACT
In these findings, I will refer to the claimant by her first name and to the defendant employer as Bakers’ Square.
From my observation of her demeanor at hearing including body movements, vocal characteristics, eye contact and facial mannerisms while testifying in addition to consideration of the other evidence, I find Lelah credible.
Lelah worked for Vicorp in their Bakers’ Square restaurant only a few days before her injury as a waitress. Lelah testified that on August 30, 1996, while carrying large trays which blocked her view, she stumbled on boxes lying on the floor and fell to the floor using her hands to break her fall. After reporting the incident, she was sent by Bakers’ Square for treatment to Iowa Methodist Medical Center emergency room and she was referred by that facility for further care to Wesley Brown, M.D., medical director of occupational medicine at Methodist hospital. Dr Brown continued care of Lelah for bilateral wrist, shoulder, upper back and neck pain until 10/15/96 at which time he learned that Bakers’ Square was denying Lelah’s workers’ compensation claim.
Defendants submitted medical records showing the Lelah has a history of falls before and after this incident and of knee and hip problems. She was previously treated for low back pain. This is not unusual as Lelah is rather overweight. However, Dr. Brown opines clearly that his treatment is related to her fall at Bakers’ Square. Defendants have offered no medical opinion to controvert the views of Dr. Brown.
The only bills submitted for reimbursement consist of the initial emergency treatment at Methodist hospital and subsequent care by Dr. Brown.
I find that on or about August 30, 1996, Lelah suffered an injury to her wrists, arms, shoulder, back and neck while working as a waitress for Bakers’ Square. Consequent, she suffered a work injury at that time which arose out of and in the course of her employment. If find that the bills incurred at Iowa Methodist Medical Center constitute reasonable and necessary treatment of this work injury.
I find that all of the requested expenses are for care authorized by defendants or referred by authorized providers and no notice otherwise was received by anyone until the notice to Dr. Brown and the subsequent termination of his care.
I find that according to exhibit 6, claimant used her personal vehicle to travel to and from medical appointments to treat the work injury a total of 92 miles.
CONCLUSIONS OF LAW
I. Claimant has the burden of proving by a preponderance of the evidence that claimant received an injury arising out of and in the course of employment. The words "out of" refer to the cause or source of the injury. The words "in the course of" refer to the time and place and circumstances of the injury. See generally, Cedar Rapids Community Sch. v. Cady, 278 N.W.2d 298 (Iowa 1979); Crowe v. DeSoto Consol. Sch. Dist., 246 Iowa 402, 68 N.W.2d 63 (1955). An employer takes an employee subject to any active or dormant health impairments. A work connected injury that more than slightly aggravates the condition is considered to be a personal injury. Ziegler v. United States Gypsum Co., 252 Iowa 613, 620, 106 N.W.2d 591 (1961) and cases cited therein..
In the case sub judice, I found that claimant carried the burden of proof and demonstrated by the greater weight of the evidence that she suffered the work injury as alleged.
II. Pursuant to Iowa Code section 85.27, claimant is entitled to payment of reasonable medical expenses incurred for treatment of a work injury.
In the case at bar, I found that the requested expenses were causally connected to the work injury and authorized. They will be awarded to claimant along with $.24 per mile for medical mileage. 876 IAC 8.1(2).
ORDER
1. Defendants shall pay the medical expenses set forth in exhibit 3 for care by the Iowa Methodist Medical center staff and Wesley Brown, M.D. between August 30, 1996, through October 15, 1996. Claimant shall be reimbursed for any of these expenses paid by her. Otherwise, defendants shall pay the provider directly along with any lawful late payment penalties imposed upon the account by the provider. Defendant shall also pay to claimant the sum of twenty-two and 08/100 dollars ($22.08) for medical mileage.
2. Defendants shall pay interest on weekly benefits awarded herein pursuant to Iowa Code section 85.30.
3. Defendants shall pay the costs of this action pursuant to rule 876 IAC 4.33, including reimbursement to claimant for any filing fee paid in this matter.
4. Defendants shall file activity reports on the payment of this award as requested by this agency pursuant to rule 876 IAC 3.1.
Signed and filed this ______day of June, 2000.
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LARRY P. WALSHIRE DEPUTY WORKERS’
COMPENSATION COMMISSIONER
Copies to:
Mr. Robert A. Wright, Jr.
Attorney at Law
3839 Merle Hay Rd., STE 229
Des Moines, IA 50310
Mr. Harry W. Dahl
Attorney at Law
974 73rd St., STE 16
Des Moines, IA 50312